Ex-Lax Chocolated(trade name),
Fletchers’ Castoria(trade name),
Maximum Relief Ex-Lax(trade name),
Pregnancy Category: C
Pharmacologic: stimulant laxatives
Pharmacologic: stimulant laxatives
Treatment of constipation, particularly when associated with:
- Slow transit time,
- Constipating drugs,
- Irritable or spastic bowel syndrome,
- Neurologic constipation.
Active components of senna (sennosides) alter water and electrolyte transport in the large intestine, resulting in accumulation of water and increased peristalsis.
Absorption: Minimally absorbed following oral administration.
Metabolism and Excretion: Unknown.
Time/action profile (laxative effect)
|PO||6–12 hr†||unknown||3–4 days|
Contraindicated in: Hypersensitivity;Abdominal pain of unknown cause, especially if associated with fever;Rectal fissures;Ulcerated hemorrhoids;Known alcohol intolerance (some liquid products).
Use Cautiously in: Chronic use (may lead to laxative dependence);Possible intestinal obstruction; Obstetric / Lactation: Safety not established.
Adverse Reactions/Side Effects
- cramping (most frequent)
- diarrhea (most frequent)
- pink-red or brown-black discoloration of urine
Fluid and Electrolyte
- electrolyte abnormalities (chronic use or dependence)
- laxative dependence
Drug-Drug interactionMay ↓ absorption of other orally administered drugs because of ↓ transit time.
Route/DosageLarger doses have been used to treat/prevent opioid-induced constipation. Consult labeling of individual OTC products for more speceific dosing information
Oral (Adults and Children >12 yr) 12–50 mg 1–2 times daily.
Oral (Children 6–12 yr) 6–25 mg 1–2 times daily.
Oral (Children 2–6 yr) 3–12.5 mg 1–2 times daily.
Availability (generic available)Noted as sennoside content
Tablets: 6 mgOTC, 8.6 mgOTC, 15 mg OTC, 17 mgOTC, 25 mgOTC
Granules: 15 mg/5 mLOTC, 20 mg/5 mLOTC
Syrup: 8.8 mg/5 mLOTC
Liquid: 25 mg/15 mLOTC, 33.3 mg/mL senna concentrateOTCIn combination with: psyllium and docusateOTC. See combination drugs.
- Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
- Assess color, consistency, and amount of stool produced.
Potential Nursing DiagnosesConstipation (Indications)
Diarrhea (Side Effects)
- Oral: Take with a full glass of water. Administer at bedtime for evacuation 6–12 hr later. Administer on an empty stomach for more rapid results.
- Shake oral solution well before administering.
- Granules should be dissolved or mixed in water or other liquid before administration.
- Advise patient that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence.
- Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake, and increasing mobility. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk.
- Inform patient that this medication may cause a change in urine color to pink, red, violet, yellow, or brown.
- Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver).
- Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present.
- A soft, formed bowel movement.
Drug Guide, © 2015 Farlex and Partners
A trademark for an over-the-counter laxative containing sennosides.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.